Comorbid trichotillomania and attention-deficit hyperactivity disorder in adults

• Published in: Comprehensive psychiatry Vol. 116; p. 152317
• Main Authors: Chesivoir, Eve K., Valle, Stephanie, Grant, Jon E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2022; Elsevier Limited; Elsevier
• Subjects: ADHD; Adult; Adults; Amphetamines; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit hyperactivity disorder; Comorbidity; Hair; Health care access; Humans; Hyperactivity; Impulsivity; Mental disorders; Mental health care; Obsessive compulsive disorder; Psychiatric Status Rating Scales; Quality of Life; Self destructive behavior; Stimulant medications; Substance abuse treatment; Trichotillomania; Trichotillomania - diagnosis; Trichotillomania - epidemiology; Trichotillomania - psychology; Stimulant medications; ADHD; Impulsivity; Comorbidity; Trichotillomania
• ISSN: 0010-440X; 1532-8384; 1532-8384
• DOI: 10.1016/j.comppsych.2022.152317

Individuals with trichotillomania (TTM), a disorder characterized by repetitive pulling out of one's own hair, often have co-occurring ADHD, but little is known about this comorbidity. Additionally, there have been intimations in the literature that treatment of ADHD with stimulants may worsen TTM symptoms. This study aims to examine clinical aspects of individuals with TTM and co-occurring ADHD. 308 adults with a current diagnosis of TTM were assessed for ADHD using the Mini International Neuropsychiatric Interview 7.0.2 and Adult ADHD Self Report Scale. Participants also completed clinical measures related to TTM severity, impulsivity, quality of life, and psychosocial dysfunction. A series of analyses of variance were used to calculate differences in scale scores among subjects with and without co-occurring ADHD. Of the 308 participants, 47 (15.3%) met the clinical threshold for ADHD. Participants with ADHD reported significantly higher scores in all first and second factor traits of impulsivity, including attentional impulsiveness (p < .0001), motor impulsiveness (p < .0001), and non-planning impulsiveness (p < .0001). Interestingly, participants with ADHD did not report significant differences in TTM severity, perceived quality of life, or functional impairment, regardless of medication status. The data suggest that ADHD is common in adults with TTM, and the comorbidity is associated with heightened impulsivity. The co-occurrence of ADHD does not affect individuals' quality of life, symptom severity, or functionality. Taking stimulant medications for ADHD also did not appear to affect TTM severity, despite past case reports suggesting these medications may lead to onset or worsening of TTM. •ADHD was more prevalent in adults with trichotillomania than in the general adult population•Adults with comorbid trichotillomania and ADHD showed higher levels of impulsivity•Trichotillomania severity was unaffected by stimulant ADHD medications•ADHD status had no effect on trichotillomania severity, quality of life, and functional impairment.